Nikolos William Boehmer, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10175 Issued in NC

Practice address

4330 Southport Supply Road
Suite 201
Southport, NC 28461

Phone

(910) 457-0113

Fax

(910) 457-0114

NPI assigned

Jan 12, 2006

Last updated

Mar 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Duke University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Rehabilitation IncGroup PAC ID 8628018843, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carolina Rehabilitation Inc

  dba Brunswick P.T. Associates, Edwards & Associates P.T.

  • Physical Therapist
  • Supply, NC
  • NPI 1427142561
  Medicare reassignment Care Compare group NPD
• Proactive Therapy of North Carolina Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Raleigh, NC
  • NPI 1689679433
  NPD (past)
• Select Physical Therapy Holdings Inc

  dba Select Physical Therapy

  • Rehabilitation Clinic/Center
  • Bethany, OK
  • NPI 1437110020
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1174502645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 SOUTHPORT SUPPLY ROAD",
            "address_2": "SUITE 201",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "28461",
            "telephone_number": "910-457-0113",
            "fax_number": "910-457-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 SOUTHPORT SUPPLY ROAD",
            "address_2": "SUITE 201",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "28461",
            "telephone_number": "910-457-0113",
            "fax_number": "910-457-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHMER",
        "first_name": "NIKOLOS",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "10175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darrelle L. Biddix, PT
• Donald Edward Binz II, MD
• Kathleen P Biron, PT
• Shelby Kae Boatwright, PT, DPT
• Jessica D Bocook, D.O.
• Boiling Spring Lakes Family Medicine, PC
• Boss Urgent Care PLLC
• Elissa B Both, LCSW
• Brad L. Hilaman MD PA
• Lauren Davis Brady

• Physical Therapist in Southport, NC
• Providers in Southport, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.